"When you experience a medical emergency, you expect to be treated by a licensed physician with expertise in your condition. But what happens when you look up from your hospital gurney to find that the doctor has been replaced by a non-physician practitioner with just a fraction of the training and experience? From the co-author of Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare, the first book to warn about the systematic replacement of physicians, comes Patients at Risk: Imposter ...
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"When you experience a medical emergency, you expect to be treated by a licensed physician with expertise in your condition. But what happens when you look up from your hospital gurney to find that the doctor has been replaced by a non-physician practitioner with just a fraction of the training and experience? From the co-author of Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare, the first book to warn about the systematic replacement of physicians, comes Patients at Risk: Imposter Doctors, an even more frightening expos of patient endangerment at the hands of for-profit corporate entities and healthcare conglomerates. In the two years since Patients at Risk debuted, the use of nonphysician practitioners has skyrocketed. Employment of nurse practitioners is projected to grow by 40% and physician assistants by 28% in the next ten years. At the same time, the employment of physicians and surgeons is projected to grow just 3%. In other words, if you haven t already been treated by a nonphysician practitioner instead of a physician, you soon will be. The disproportionate growth in healthcare providers reflects thirty years of U.S. healthcare policy, as influenced by nonphysician lobbyists and corporate strategists. While corporations and government agencies argue that they have been forced to hire nurse practitioners and physician assistants due to a supposed physician shortage, the truth is far more sinister. Physicians are being systematically fired and replaced by lesser trained clinicians for one simple reason: to make money. Advocates for nonphysician practice claim that there is no need for concern because nurse practitioners and physician assistants are just as good as physicians. They are wrong. Despite over fifty years of scientific analysis of the care provided by nonphysicians, there is no conclusive evidence that nonphysician practitioners can provide safe and effective medical care without physician oversight. In fact, new studies have shown the opposite: that the replacement of physicians puts patients at risk. The book Imposter Doctors exposes the dangers of a healthcare system that increasingly prioritizes profits over patient care. The only cure for today s healthcare crisis is for patients to become informed about who is providing their care. They must know the difference in training and education, and they must demand answers from those who would deprive them of physician-led care"--
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In her latest book, Rebekah Bernard continues to cater to individuals who hold negative opinions toward nurse practitioners and physician assistants. This includes undergraduate pre-med students, medical students, resident physicians, attending physicians, and those who strongly advocate for "patient safety." Her approach in this book is more aggressive than in her previous work.
She is helping to perpetuate a movement through her work that, on the surface, says it aims to protect patients: which, in truth, is noble. However, beneath the surface, you find animosity, hatred, and prejudice that will, if left unchecked, endanger patient outcomes.
Why? Because ultimately, the message is to:
1. Not supervise NPs/PAs
2. Not work with them
3. Not take referrals from them
4. Scour the internet for moments they make a mistake and use it as anecdotal evidence to generalize.
5. Create a hostile work environment
6. Paternalistically dictate what autonomous professions can and cannot do.
7. Maintain physician hegemony over healthcare
8. Abolish the NP profession (there is a special place in Bernard's heart for the NPs)
There is also an apparent and notable obsession with providing anecdotal evidence to demean/broad-stroke views on professions that are boots on the ground, overwhelmingly doing much more beneficence than maleficence. The content primarily centers around denigrating NPs or PAs as second-rate compared to others. The language used to convey the message may be carefully worded and refined, but the tone is far from pleasant.
Healthcare is available in numerous settings, and unfortunately, some doctors, such as Bernard, only concentrate on emergency cases. Although having well-trained physicians available during emergencies is crucial, what about other essential healthcare environments that are not emergent?
There is, here, a pressing cultural issue that needs urgent attention. It's concerning that so many are participative and actively contributing to a harmful and hostile environment that impacts everyone involved. We must acknowledge the significant role that physicians play in this hierarchy and their considerable power, and how a movement like Bernard's can have detrimental effects on the healthcare team.
Dear reader, it is crucial to stay alert and analyze any evidence. Please be careful of anecdotal evidence and consider the level of empirical evidence. It is essential to be mindful of confirmation bias, selection bias, and the abundance of peer-reviewed evidence that may counter many of Bernard's positions. If a movement promotes prejudice, demonization, harassment, or ostracizes certain groups, it is necessary to question whether or not it is fulfilling its intended purpose.
After reading her original book and now this gem, I reflect more than ever that no profession is immune to human error, avarice, malpractice, and other imperfections. Nonetheless, as you read through the pages, please remember that as NPs and PAs, we remain dedicated to being at the forefront of delivering healthcare services. Our mission is to save lives, relieve suffering, provide care to the vulnerable during their most difficult moments, and improve access to healthcare across the United States.
